İnterspinöz ligamentte dejeneratif değişimler

Yıl 2014, , 661 - 666, 16.01.2015

Jian-Feng Zhang Chao Liu He-Jun Yu Hong-Xin Cai Shun-Wu Fan

https://doi.org/10.3944/AOTT.2014.13.0149

Öz

Amaç: Bu çalışmanın amacı bel ağrısı (BA) bulunan hastalarda interspinöz ligament dejenerasyonunun (İSLD) radyolojik bulgularının değerlendirilmesi idi.

Çalışma planı: Çalışmadaki gruplar BA bulunan 60 olgu (Grup A) ve yaş ve cinsiyet frekansları eşleşen 60 diğer olgudan (Grup B) oluşmaktaydı. İSLD için MRG tabanlı bir derecelendirme sistemi ile yapılan skorlama Tip A (normal) ile Tip D (şiddetli) arasında dağılım gösterdi. Dört lomber seviyedeki dejenerasyona göre lomber diskin derecelendirmesi yapıldı.

Bulgular: Grup A’da 161 (%67.1), Grup B’de 172 (%71.7) seviyede rastlanan Tip A en fazla rastlanan İSLD tipi oldu. Tip D en az rastlanan tipti ve Grup A’da 13, Grup B’de ise 3 seviyede görüldü. Tip D İSLD’nin Grup A’daki insidansının (%5.4) Grup B’ye (%1.3) oranla anlamlı derecede yüksek olduğu saptandı (p<0.05). Grup A’da Tip D İSLD görülen hastaların yaşının Tip A, B ve C’ye göre daha yüksek olduğu belirlendi (Tip A ve B için p<0.01, Tip C için p<0.05). Grup B’de Tip D İSLD bulunan hastaların yaşı Tip A hastalara göre anlamlı derecede yüksekti (p<0.05). İSLD’nin ileri safhalarında her iki grupta da disk derecesinin arttığı görülse de, sadece Grup D’deki Tip D ile Tip A ve B arasındaki fark istatistiksel olarak anlamlı idi (p<0.05).

Çıkarımlar: Bel ağrısı olan veya olmayan hastalarda ileri derecede İSLD’ye daha az rastlanmaktadır. İSL’nin ileri derecede değişiminin BA olan hastalarda daha sık olduğu görülmüştür. Daha şiddetli disk dejenerasyonunda İSLD oluşmaktadır.

Anahtar Kelimeler

İnterspinöz ligament; intervertebral disk; lomber omurga; manyetik rezonans görüntüleme (MRG).

Degenerative changes in the interspinous ligament

Öz

Objective: The aim of this study was to investigate the imaging assessment of interspinous ligament degeneration (ISLD) in patients with or without low back pain (LBP).

Methods: Sixty patients with LBP were enrolled in Group A and 60 subjects frequency-matched by age and sex in Group B. An MRI-based grading system for ISLD was scored and ranged from Type A (normal) to Type D (severe). The lumbar disc was also graded according to degeneration at four lumbar levels.

Results: Type A ISLD was the most prevalent type with 161 levels (67.1%) in Group A and 172 (71.7%) in Group B. Type D was the least frequent, seen in 13 levels in Group A and 3 in Group B. There was a significantly higher incidence of Type D ISLD in Group A than Group B (5.4% vs. 1.3%, p<0.05). The average age of patients with Type D ISLD in Group A was higher than Types A, B and C (Type A and B p<0.01, Type C p<0.05). In Group B, the age of patients with Type D ISLD was significantly higher than those with Type A (p<0.05). Although disc grade increased in advanced ISLD in both groups, only the difference between Type D and Types A and B in Group A were statistically significant (p<0.05).

Conclusion: More advanced ISLD grades were less common in patients with or without LBP. Advanced change of the ISL was more common in patients with LBP. ISLD occurred in more severe disc degeneration.

Anahtar Kelimeler

Interspinous ligament, intervertebral disc, lumbar spine, magnetic resonance imaging (MRI)

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